A recent report by the Centers for Medicare and Medicaid Services (CMS) found that individuals with mental health or behavioral problems are more likely to be denied access to higher-quality nursing homes throughout the country. The study relied on data from 3.7 million admissions in 15,600 facilities across the country and found that, while elderly Americans with any type of mental health problem faced more difficulty, those diagnosed with more severe illnesses faced even longer odds of admittance. According to healthcare analysts, this is likely a combination of concerns surrounding individuals with mental health problems and a lack of high-quality nursing homes in lower-income areas, which are more likely to have senior citizens with mental health challenges.

CMS assigns a “grade” to each nursing home based on the number of staff at each facility relative to the number of residents, quality benchmarks and the results of health inspections. CMS then assigns a set number of stars to the facility representing its quality, with a one-star facility providing the lowest quality care and a five-star facility providing the highest.

According to the report’s findings, a person with bipolar disorder is 11 percent less likely to gain admittance to a five-star facility. For individuals diagnosed with schizophrenia or with substance abuse problems, they are approximately 30 percent less likely. Personality disorders lower the odds by 32 percent.

While research has always shown there is a lower admittance rate for individuals with serious mental health disorders, this study is the first to show that more common mental illnesses, such as anxiety and depression, can also affect a person’s chances. According to the study, people with depression were 8 percent less likely to enter a five-star nursing home. Though, unlike the other mental health issues researched by CMS, they were only 1 percent more likely to enter a one-star facility. For individuals with bipolar disorder, schizophrenia, substance abuse problems, or behavioral health issues, there is an 11 to 28 percent higher likelihood of entering a one-star facility.

Elder care advocates point to several causes for the reduced access senior citizens may face because of their mental health struggles. First, many five-star or high-quality facilities are in wealthier areas, which tend to have lower rates of mental illness and cost more. But while geography and a high price tag may explain some of the problem, it also appears that facilities are selectively choosing to admit residents with fewer mental health issues. Simply, it is more expensive to treat individuals with complex health problems. According to nursing homes, too many residents with severe mental health struggles would require an amount of attention and expense that would lower the quality of care for other residents.